Perioperative behavioral therapy and pelvic muscle strengthening do not enhance quality of life after pelvic surgery: Secondary report of a randomized controlled trial
Open accessAbstract
Background: There is significant need for trials evaluating the long-term effectiveness of a rigorous program of perioperative behavioral therapy with pelvic floor muscle training (BPMT) in women undergoing transvaginal reconstructive surgery for prolapse. Objective: The purpose of this study was to evaluate the effect of perioperative BPMT on health-related quality of life (HRQOL) and sexual function following vaginal surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Design: This study is a secondary report of a 2 × 2 factorial randomized controlled trial. Setting: This study was a multicenter trial. Participants: Participants were adult women with stage 2–4 POP and SUI. Intervention: Perioperative BPMT versus usual care and sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS) were provided. Measurements: Participants undergoing transvaginal surgery (SSLF or ULS for POP and a midurethral sling for SUI) received usual care or five perioperative BPMT visits. The primary outcome was change in body image and in Pelvic Floor Impact Questionnaire (PFIQ) short-form subscale, 36-item Short-Form Health Survey (SF-36), Pelvic Organ Prolapse-Urinary Incontinence Sexual Questionnaire short form (PISQ-12), Patient Global Impression of Improvement (PGII), and Brink scores. Results: The 374 participants were randomized to BPMT (n = 186) and usual care (n = 188). Outcomes were available for 137 (74%) of BPMT participants and 146 (78%) of the usual care participants at 24 months. There were no statistically significant differences between groups in PFIQ, SF-36, PGII, PISQ-12, or body image scale measures. Limitations: The clinicians providing BPMT had variable expertise. Findings might not apply to vaginal prolapse procedures without slings or abdominal apical prolapse procedures. Conclusions: Perioperative BPMT performed as an adjunct to vaginal surgery for POP and SUI provided no additional improvement in QOL or sexual function compared with usual care.
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“Weidner et al. (2017) [47] also found no significant differences in pelvic floor impact (PFIQ), sexual function (PISQ-12), body image, or general health (SF-36) at 24 months be-tween BPMT and standard care.”
- Authors
- Weidner, A. C., Barber, M. D., Markland, A., Rahn, D. D., Hsu, Y., Mueller, E. R., Jakus-Waldman, S., Dyer, K. Y., Warren, L. K., Gantz, M. G., & Meikle, S.
- Affiliations
- Duke University (US)
- Cleveland Clinic (US)
- University of Alabama at Birmingham (US)
- The University of Texas Southwestern Medical Center (US)
- University of Utah (US)
- Loyola University Medical Center (US)
- Kaiser Permanente (US)
- Kaiser Permanente San Diego Medical Center (US)
- RTI International (US)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (US)
- Corresponding author
- Weidner, Alison C.
- ORCID
- Venue
- Physical Therapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-07-29
- Volume
- 97
- Issue
- 11
- Pages
- 1075-1083
- ISSN
- 0031-9023 (ISSN-L)
- 1538-6724
- PMC
- PMC6075557
- OpenAlex
- W2782511226
- Cited by
- 15
- References
- 27
- Citations by year
- 2025: 1 · 2024: 2 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 1
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Physical Therapy (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- National Institutes of Health (U01 HD41249, U10 HD41250, U10 HD41261, U10 HD41267, U10 HD54136, U10 HD54214, U10 HD54215, U01 HD069031, U10 HD54241)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Keywords
- pelvic floor muscle training, pelvic organ prolapse, stress urinary incontinence, sacrospinous ligament fixation, uterosacral ligament suspension, midurethral sling, health-related quality of life, sexual function, body image
- MeSH terms
- Behavior Therapy, Body Image, Female, Humans, Middle Aged, Quality of Life, Surveys and Questionnaires, Sexual Behavior, Treatment Outcome, Perioperative Care, Suburethral Slings, Resistance Training, Pelvic Organ Prolapse
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